Designing and testing self-help interventions (original) (raw)
Handbook of Self-Help Therapies
Routledge eBooks, 2007
Self-Help Interventions Mapping the Role of Self-Administered Treatments in Health Care GEORGE A. CLUM Th e last 30 years have witnessed the publication of a torrent of books aimed at transforming the average American citizen into a successful business and fi nancial entrepreneur who is at once thin, muscular, fi t, free of illness and disease, and content with life. Th is transformation is to be achieved at the hands of none other than the average citizen herself, for the vehicle that will provide this metamorphosis is the self-help book or program in the hands of this same citizen. In the health arena, this change guru might be someone who has personally overcome disease or disorder or who has systematized an approach whose change formula will help suff erers overcome their defi ciencies. Th e number of books dedicated to this enterprise has expanded to the point where the New York Times provides a separate rating system of the most successful. Clearly, the self-help book has become a major factor in the domain of self-improvement. Th e assumption of the majority of these books is that the success stories detailed within will provide the motivational prod to stir the consumer to action and that, once so stirred, the technology advocated will be employed and the intended change produced. Th e extrapolated message is obvious: " I've been able to do it. Follow my formula and you will too!" or "I've shown that this formula has transformed others. Use it and transform yourself!" Almost without exception, the purveyors of change have failed to examine whether ER51712_C003.indd 41 ER51712_C003.
A meta-analysis of self-help treatment approaches
Clinical Psychology Review, 1993
We conducted a meta-analysis of40 self-help studies examining 61 treatments which used as control groups no-treatment, wait-list, or phuebo comparisons. We found an overall treatment effect size for self-help interventions of 0.76 at posttreatment and an effect size of 0.53 atfollow-up. Studies that used a more stringent control group -placebo-had a lower mean effect size than studies utilizing a no-treatment control. No differences were foundfor unadulterated self-help treatments and those with minimal contact from a therapist or which were in fact therapist-assisted, Some target problems were more amenable to self-help approaches, including skills deficits and diagnostic problems, stub as fears, depression, he&he, and sleep disturbance. Habit disturbances such as smoking drinking, and overeating, were less amenable to self-help treatments. Compliance with the treatment regimen was found to improve treatment effects. While effect size was negatively related to duration of treatment, this effect was largely a function of duration being confounded with type of problem. Results were examinedfrom the perspective of problems that are targetable with selfhelp approaches. Recommendations for improvements in research design for future studies are also made. echoed the conclusions of an earlier review . By 1987, however, Rosen, while noting the potential benefits of self-help materials, was much less hopeful and, indeed, was focusing on the many risks of such materials. The present review sought to bring the basic question of the effectiveness of self-help materials up to date. It was further interested in applying meta-analytic methodology to this task. Such an approach permitted a much more comprehensive analysis of the benefits and limitations of this field. The previous reviews of this literature left a number of unanswered questions. First was the issue of whether self-help materials were effective. Because of the vast differences in methodological rigor among studies reviewed, it was impossible for Glasgow and Rosen to
Journal of consulting and clinical psychology, 2011
The effectiveness of self-help materials may be constrained by failures to undertake recommended exercises or to deploy the techniques that one has learned at the critical moment. The present randomized controlled trial investigated whether augmenting self-help materials with if-then plans (or implementation intentions) could overcome these problems and enhance the self-management of anxiety symptoms. Method: At baseline, participants who reported anxiety symptoms completed the Hospital Anxiety and Depression Scale (HADS) and the state version of the State-Trait Anxiety Inventory (STAI). Participants were then randomized via a computer program to standard self-help (n ϭ 86), augmented self-help (n ϭ 90), or no-intervention (n ϭ 86) conditions. Eight weeks later, 95% (n ϭ 249) of the participants completed the HADS and STAI again. Results: Findings showed a significant reduction in anxiety in the augmented self-help condition compared with both the standard self-help and nointervention conditions (caseness rates on the HADS at follow-up were 21%, 49%, and 44%, respectively). Mediation analyses indicated that the benefits of augmented self-help materials were explained by improved detection of anxiety-related triggers and greater experienced benefits of the self-help techniques. Conclusions: These findings suggest that implementation intentions offer a valuable supplement to self-help materials that can enhance their impact on outcomes.
Integrating self-help materials into mental health practice
Canadian family physician Médecin de famille canadien, 2008
Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively. To aid health professionals in integrating self-help materials into their mental health practices. A resource library of print, audiotape, and videotape self-help materials about common mental health issues was developed for a rural community. The materials were prescreened in order to ensure high quality, and health professionals were given training on how to integrate self-help into their practices. The library was actively used by both health professionals and community members, and most resources were borrowed, particularly the nonprint materials. Health professionals viewed the resources as a way to supplement their mental health practice and reduce demands on their time, as patients generally worked through th...
An Introduction to Psychosocial Interventions
Psychosocial Interventions in Mental Health Nursing, 2015
Domain 1: Professional values 4.1 Mental health nurses must work with people in a way that values, respects and explores the meaning of their individual lived experiences of mental health problems, to provide person-centred and recovery-focused practice. 5. All nurses must fully understand the nurse's various roles, responsibilities and functions, and adapt their practice to meet the changing needs of people, groups, communities and populations. Domain 2: Communication and interpersonal skills Mental health nurses must practise in a way that focuses on the therapeutic use of self. They must draw on a range of methods of engaging with people of all ages experiencing mental health problems, and those important to them, to develop and maintain therapeutic relationships. They must work alongside people, using a range of interpersonal approaches and skills to help them explore and make sense of their experiences in a way that promotes recovery. 5. All nurses must use therapeutic principles to engage, maintain and, where appropriate, disengage from professional caring relationships, and must always respect professional boundaries. 5.1 Mental health nurses must use their personal qualities, experiences and interpersonal skills to develop and maintain therapeutic, recovery-focused relationships with people and therapeutic groups. They must be aware of their own mental health, and know when to share aspects NMC Essential Skills Clusters (ESCs) Cluster: Care, compassion and communication 6. People can trust the newly registered graduate nurse to engage therapeutically and actively listen to their needs and concerns, responding using skills that are helpful, providing information that is clear, accurate, meaningful and free from jargon.
The Cognitive Behaviour Therapist
Guided CBT self-help represents a low-intensity intervention to deliver evidence-based psychological therapy within the Improving Access to Psychological Therapies (IAPT) programme. Best practice guidance highlighting characteristics associated with CBT self-help is available to help services reach decisions regarding which interventions to adopt. However, at present a single process to evaluate written CBT self-help interventions informed by guidance is lacking. This study reports on the development of a standardised criteria-driven process that can be used to determine the extent written CBT self-help interventions are consistent with guidance regarding the fundamental characteristics of low-intensity CBT and high-quality written patient information. Following development, the process was piloted on 51 IAPT services, with 23 interventions identified as representing free-to-use written CBT self-help interventions. Overall, inter-rater reliability was acceptable. Following applicati...
Good practice guidance on the use of self-help materials within IAPT services
This guide was produced following an Improving Access to Psychological Therapies (IAPT) Conference held at the Queens Hotel in Leeds in February 2009. The conference had been organised in response to feedback from services and those attending training courses expressing a need for expert guidance on the use of self-help materials given the wide range of different materials and media all purporting to offer helpful advice and information to people about a range of problems and disorders.
Self-help is no help: negative study results lead to important lessons
Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la médecine rurale : le journal officiel de la Société de médecine rurale du Canada, 2014
PROBLEM ADDRESSED Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively.
International Journal of Wellbeing, 2023
Brief, self-help positive psychology interventions (PPIs) have certain advantages over longer, guided interventions (e.g. higher completion rates). The "Miracle Question(s)"the most famous intervention in solution-focused therapy and coaching-appears to be a promising brief, self-help PPI. However, very little experimental research on the "Miracle Question" has been conducted. The present study investigated the effects of a brief self-help MQ intervention on several aspects of wellbeing, including hope, expectancy, goal clarity and affect. The MQ intervention was compared against both a problem-focused and neutral coaching approach. Three online experiments were conducted with participants aged 18-76 across the world. Two experiments focused on "life problems" whilst the third focused on problems in interpersonal relationships. Results suggested that all three interventions raise expectancy in the context of life (but not relationship) problems. However, as hypothesised, the relative effects of such interventions may depend on openness-to-experience. At high[low] levels of openness-to-experience, the MQ technique was more[less] effective than the problemfocused or neutral coaching interventions, at least for some aspects of wellbeing. The study sheds much-needed light on the MQ technique and on brief self-help interventions. Widely recommended as a means of enhancing wellbeing, the MQ technique may not be universally effective (in a self-help format) and requires further investigation. On the other hand, the study suggests that brief self-help computerized PPIs may indeed be enthusiastically adopted, especially when compared with longer interventions.
Professional Psychology-research and Practice, 2011
How do psychologists in clinical practice perceive and use self-help materials for clients with anxiety and depression? The use of self-help materials with guidance from a therapist has been suggested as a way of meeting the increasing need for mental health services. The present study investigated factors relevant to the use of self-help materials for the treatment of anxiety and depression among psychologists employed in mental health services. Among 1863 eligible clinical psychologists in Norway, 815 (43.7%) participated in a national survey. A total of 93.5% of the participants had recommended self-help materials to clients, and approximately half (55.1%) had received requests from their clients regarding self-help materials. Self-help materials were recommended as an adjunct and not as an alternative to therapist contact by 73.0% of respondents, by 16.6% for relapse prevention, and by 1.2% to clients on a waiting list. Internet/computer-based programs were recommended by 2.2% of the participants. The practitioner's previous use of self-help materials to enhance his or her therapy skills and knowledge of self-help materials was related to use of self-help materials with clients. Psychologists working in child mental health services recommended self-help less often than those working in adult services. These results have implications for future efforts to disseminate effective self-help materials through increased attention toward self-help interventions in training and clinical practice.
Randomized Controlled Feasibility Trial of a Self-Help Book for Health Anxiety
2012
Bovell, candidate for the degree of Doctor of Philosophy in Psychology, has presented a thesis titled, Randomized Controlled Feasibility Trial of a Self-Help Book for Health Anxiety, in an oral examination held on March 30, 2012. The following committee members have found the thesis acceptable in form and content, and that the candidate demonstrated satisfactory knowledge of the subject material.
Guided Letter Writing: A Long Brief Therapy Method Whereby Clients Carry Out Their Own Treatment
The Journal of strategic and systemic therapies, 1992
This paper describes an innovation in psychotherapy that was initiated by the first author in 1979. It draws upon clients' resources in being able to express themselves in writing rather than relying on the spoken word alone. Terpager found that clients were able to carry out much of the therapeutic work on their own through the process of writing letters. Although he has elaborated and refined his method since it was first developed, it still remains largely unknown. The second author became aware of tllis work in 1988 and began using it occasionally as well. Tomm eventually agreed to help prepare this brief description ofTerpager's method so tlUlt it could become more widely available. The paper is not intended to review the literature on writing in therapy, but to outline a single systematic approach. Origins Like many other clinicians, Terpager discovered that clients often found it useful to write about personal experiences as a way to explore them, clarify them, and render them less problematic. For instance, fairly early in his career as a Danish psychiatrist, he was working with a client who was struggling with unresolved grief. He suggested that the client write
A meta-analytic study of self-help interventions for anxiety problems
Behavior Therapy, 2006
The present study examined the effectiveness of self-help (SH) interventions for individuals with anxiety problems. Thirty-three studies, targeting a variety of anxiety disorders and problems, met criteria for inclusion with 1,582 clinical and subclinical participants. Self-help formats included books, audio/videotapes, and computer/Internet-based programs. The average effect sizes (Cohen's ds) comparing SH interventions to control groups for target symptoms were .62 at posttreatment and .51 at follow-up. When compared to therapist-directed interventions (TDIs), the average effect sizes (Cohen's ds) for target problems were −.42 at posttreatment and −.36 at follow-up. Format of SH materials, type of target disorder, presence of minimal therapist contact, and other study parameters were examined for their effect on treatment outcome. The results were discussed from the perspective of a stepped-care approach for anxiety problems.
Development of an Intervention to Promote Self-Care: Needs Assessment
SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference
The global societal challenges reveal decreased ability of people to maintain health and well-being when faced with prolonged stress conditions. Increases in anxiety, depression, and burnout are reported worldwide. The recent research indicates self-care as a useful resource to promote health and well-being and strengthen psychological resilience. The importance and attainability of self-care strategies are the characteristics that may indicate the necessity for self-care behaviour changes by identifying an internal conflict between the two. However, little is known about the determinants of self-care practicing according one’s needs. The study aimed to explore the experts’ perspectives on self-care needs among clinically healthy adults. The risks caused by inadequate self-care practices and the determinants of self-care behaviour change were identified. The interviews with 12 experts in arts therapies and/or health psychology were conducted. The qualitative content analysis was use...
Clinical Psychology Review, 2012
The understanding of factors that are associated with the outcome from cognitive behavioral therapy (CBT) for anxiety disorders is limited. Identifying characteristics that are related to the treatment outcome can improve treatments and provide better criteria for matching of patients to treatments that they are likely to benefit from. This thesis investigates factors associated with the outcome from various formats of CBT for anxiety disorders, panic disorder and social anxiety disorder in particular. The thesis comprises three scientific articles that addressed the overall effect of self-help treatment, as well as study-level factors, patient characteristics, and factors related to the therapy process, as predictors and moderators of the treatment outcome from CBT provided as guided self-help, face-to-face treatment and stepped care. Methods: Paper I investigated the effectiveness of and factors associated with the outcome of self-help treatment for all anxiety disorders. The study sample comprised 56 studies with 82 comparisons of a self-help treatment to a no-treatment/placebo or another active treatment. The overall effectiveness of self-help treatment was investigated in two meta-analyses; one in which self-help was compared to a waiting list or placebo control group (n=56), and one in which self-help was compared to an active treatment (n=28). Potential study level predictors were investigated in subgroup analyses and meta-regression analyses. Papers II and III used data from a randomized controlled effectiveness trial: the "Assessment and Treatment-Anxiety in Children and Adults" (ATACA) study, which compared immediate face-to-face CBT (FtF-CBT) to a CBT-based Stepped Care treatment model for panic disorder and social anxiety disorder. The Stepped Care model comprised three steps: